City tops state in drug deaths

Lisa M. Krieger, EXAMINER MEDICAL WRITER

Published 4:00 am, Thursday, April 9, 1998

1998-04-09 04:00:00 PDT SAN FRANCISCO; CALIFORNIA -- San Francisco leads the rest of California in drug-related deaths, with twice the death rate of the state, according to a new report by state health officials.

The growing purity and decreasing cost of local heroin is driving the trend, said city drug experts.

Competition among heroin dealers here has helped push down the price of the drug to one-quarter the cost of 15 or 20 years ago, said Newmeyer. The dense urban environment of San Francisco, as well as its reputation of tolerance, also may contribute to The City's high drug-related death rate.

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The report, released this week by the state Department of Health Services, shows The City had 20.5 drug-related deaths per 100,000 people, or one death for every 4,901 residents.

This compares with a statewide average of 8 drug deaths per 100,000 residents. The lowest rate in the state was in Santa Clara County, with 4.7.

The City also ranks first in the number of cases of tuberculosis and AIDS per 100,000 residents.

The good news is that San Franciscans are less likely to die of car crashes, homicide, cancer or heart disease than the average state resident.

The City's teen pregnancy and infant mortality rates also are far below the state average. The birth rate among teens in Tulare is double that of teens in San Francisco.

The overall death rate in San Francisco has dipped slightly since last year but remains one of the highest in the state, surpassed only by Lake and Yuba counties.

The City's death rate was 547 per 100,000 residents, down from a rate of 576 in last year's report and 599 in the report before that.

The report compares 20 health-related indicators of San Francisco residents - rates of death, diseases and prenatal care - to residents of other California counties. Most of the rates are three-year averages for 1994, 1995 and 1996, the most recent data available. The data were age-adjusted, compensating for the different age compositions of county populations.

San Joaquin County is the syphilis capital of the state. Kern County ranks highest in infant mortality. Tulare County leads in teen pregnancies - and also youth poverty.

Other findings&lt;

The report also found that:

*Tulare County has the state's highest percentage of poor children and youth. Thirty-three percent of children under age 18 lived in poverty there, compared with only 6.3 percent in Marin County. About 18.6 percent of San Francisco's youth are poor. This is close to the state average of 18.2.

*The Gold Country region of Calaveras County has a death rate due to auto wrecks that is five times higher than San Francisco: 42 vs. 8 per 100,000 residents. San Mateo County, with a death rate of only 6.4, has the safest roads in the state.

*Los Angeles has the state's highest homicide rate, as well as the highest rate of deaths from firearms injuries. Los Angeles reported 19.4 homicides per 100,000 population, followed by Fresno County with 15.4 deaths. Alameda County placed fifth, with 14.3 homicides per 100,000, and San Francisco had a rate of 10.8, slightly lower than the statewide average of 11.8.

*Lake County had the highest suicide rate in the state, with 30 cases per 100,000 - more than threefold the rate of Santa Clara County, with a low of 8.6 per 100,000 cases. San Francisco's suicide rate is 15.7, significantly higher than the state average of 10.7.

*As expected, San Francisco had the highest AIDS incidence in the state, with 191 cases per 100,000 residents. This is down from 233 cases in last year's report and 291 cases the year before that. The City has three times as many AIDS cases per 100,000 residents as the statewide average - and more than 32 times the number of lowest-ranking Tulare County.

The county with the next-highest incidence of AIDS was Marin, followed by Los Angeles, San Diego, Alameda and Sonoma.

*Tuberculosis cases, perhaps related to the immune devastation of AIDS, are also most common in San Francisco. The City has 36 TB cases per 100,000 residents, compared with the state average of 14.4.

Little adequate treatment&lt;

The City's drug epidemic is an intransigent problem, worsened by the lack of adequate treatment, according to city drug-abuse experts. As of Jan. 31, there were 1,072 applicants waiting for substance-abuse treatment in public programs.

Minority populations are disproportionately affected, according to epidemiologist Al Abramowitz of the San Francisco Health Department. African Americans were hospitalized for heroin overdose at a rate threefold that of other San Franciscans. They were hospitalized for cocaine at a rate fivefold that of other city residents.

After San Francisco, the counties with the next-highest rate of drug deaths were Humboldt, Kern, Santa Barbara and San Joaquin.

"Many people pack their bags and move west," said Abramowitz, "only to find that their problems have been stowed away in their baggage." &lt;